• Neurochirurgie · Feb 2002

    Case Reports

    [Transthoracic transvertebral approach for resection of an anteriorly located, calcified meningioma. Case report].

    • B Jenny, B Rilliet, D May, and G P Pizzolato.
    • Service de Neurochirurgie, Hospital Cantonal Universitaire de Geneve, rue Micheli-du-Crest 24, CH-1211 Geneve 14, Suisse, France. benedict.rilliet@hcuge.ch
    • Neurochirurgie. 2002 Feb 1;48(1):49-52.

    AbstractWe report the case of a 61-year-old woman, who developed progressive paraparesia over a period of 8 months. Conventional X-rays of the thoracic spine showed an intra-spinal calcified lesion at T10. On CT-scan and MRI, the lesion appeared anterior to the cord, thus making a posterior approach hazardous. Total resection of this calcified meningioma was achieved through a right transthoracic transcorporeal approach, under close monitoring of the somatosensory evoked potentials. Despite a delayed pseudomeningocele formation requiring an additional thoracotomy, outcome after 7 years is excellent with no residual neurological deficit. No recurrence was seen on a CT-scan performed two years after the surgery. Calcified anterior meningiomas of the spine are rare lesions. Surgical outcome has been unfavorable for a long time in relation with posterior or postero-lateral approaches. Although anterior transthoracic procedures are routinely performed for extradural spinal lesions, this approach is rarely used for intradural lesions. A calcified anterior spinal thoracic meningioma should be managed like the more frequent calcified thoracic disk hernia, despite the increased risk of cerebrospinal fluid effusion requiring subsequent repair.

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